GN Hear & Now

TINNITUS SOUND GENERATOR

FITTING GUIDE 

The Tinnitus Sound Generator (TSG) is designed as a sound therapy tool for tinnitus management. The TSG features are the same in all technology levels and can be activated in any program.

Notes:

  • The TSG volume slider is in dBSPL. 

  • The TSG settings overlayed on the audiogram can be displayed in dBSPL or dBHL.

  • The binaural link option is not available for all features in TSG. Only Amplitude Modulation, Modulation Speed and Volume Control can be linked during the fitting.

  • For a TSG only program ensure the HI Microphone option is turned ‘Off’. 


1. Activate the TSG

  • Select the program you want to activate the TSG in.

  • Select the menu option in the upper right corner (Figure 1)

  • Under the Fitting heading, select Tinnitus Sound Generator (Figure 1)

  • Turn the Tinnitus Sound Generator slider to ‘On’ (Figure 2)

 

Figure 1

Figure 2


2. Set the TSG volume


The volume of the TSG is set using the volume slider. The volume should be set to a level that provides relief, but does not completely mask the tinnitus. (Figure 3)
Note: The volume slider is in dBSPL.

Below is a suggestion on how to first fit the TSG. It uses the threshold of audibility as a starting point.

Find the TSG threshold of audibility (three steps)

  • Using the volume slider, turn up the volume until the patient reports that they can just barely hear the TSG white noise. This is the TSG threshold of audibility. 
  • Increase the volume slider until the patient reports they can no longer hear their tinnitus over the TSG sound. This is the level at which their tinnitus is completely masked. This is the minimum masking level (MML).
  • Set the volume 5–10 dB above the threshold level. (You can go higher than 10 dB if necessary, but do not completely mask the tinnitus signal. This is where the MML is important)

Figure 3


3. Set the TSG bandwidth

  • Our TSG defaults to a broadband white noise setting. There are 4 sound preset options to choose from. They can be customized using the Range option to adjust the frequency shaping. (Figure 4)

Figure 4


4. Customize the TSG features according to patient preference

  • “Amplitude Modulation” can be activated if the patient finds it to be comfortable. (Figure 5)
  • “Amplitude Modulation” causes the TSG to fluctuate in volume, creating an “ocean-like” noise sequence. A “Mild” setting offers less fluctuation, whereas a “Strong” setting offers more fluctuation.
  • “Modulation Speed” controls how quickly the volume fluctuations occur. A “Slow” setting allows more time between fluctuations, whereas a “Fast” setting allows less time between fluctuations. (Figure 5)
  • Selecting “Synchronize” will enable ear-to-ear commu­nication, ensuring the features of the TSG are automatically functioning symmetrically. (Figure 6)

Figure 5



Figure 6


5. Customize the Volume Control options

  • The “Volume Control” options determine how the volume of the TSG will be controlled. (Figure 7)
  • Selecting “Volume Control” will reassign the function of the manual volume control to the TSG only for that program.
  • Selecting “Environmental Steering” will allow the volume of the sound generator to automatically adapt to the listening environment, ensuring comfort in all situations.
  • Selecting “Volume Control + Environmental Steering” will combine the use of these two features. It allows manual volume adjustments while the Environmental Steering features is also active.

Figure 7


6. Activating Nature Sounds

  • Nature Sounds can be used as an alternative to the standard TSG, by positioning the Nature Sounds tab to ‘On’ (Figure 8)
  • There are 6 water-inspired Nature Sound files to choose from. (Figure 8)
  • To activate a Nature Sound, click on the picture of the Nature Sound desired.
  • Note: When the same Nature Sound is selected during a binaural fitting, a stereo effect will be applied (Figure 8). The stereo effect will not be applied if different Nature Sounds are selected between instruments.
  • Advanced Settings allows you to adjust the low, mid and high frequency bands of the Nature Sound. (Figure 9) Note: It is only recommended to use this if necessary.

Figure 8


Figure 9

7. Program and save

  • To program the instruments and save to NOAH, click ‘Done’ in the lower right corner of the screen, and then click ‘Save’ in either the ‘Fit’ screen or ‘Summary’ screen. (Figure 10)

Figure 10


Tinnitus patients have great variance in their needs and preferences for successful tinnitus management. The information in this fitting guide is designed to serve as suggested starting points, and can be modified as needed for individual patients.